电针结合补中益气汤治疗眼肌型重症肌无力的临床观察  

Clinical observation of electroacupuncture combined with Buzhong Yiqi decoction in the treatment of ocular myasthenia gravis

作　　者：胡文静 杜旭[2] 李銛鋆 杜一鸣 殷克敬[3] HU Wenjing;DU Xu;LI Xianjun(Shenzhen Longhua District Central Hospital,Shenzhen 518110,China)

机构地区：[1]深圳市龙华区中心医院,深圳518110 [2]陕西中医药大学,咸阳712046 [3]陕西中医药大学第二附属医院,咸阳712000

出　　处：《中国中医眼科杂志》2021年第8期561-565,共5页China Journal of Chinese Ophthalmology

基　　金：全国名老中医传承工作室建设项目(国中医药人教发[2011]41号)。

摘　　要：目的观察电针结合补中益气汤治疗眼肌型重症肌无力(oMG)的临床效果。方法将2018年9月—2019年10月收治的40例oMG患者随机分为2组,每组20例,针药组采用电针联合补中益气汤加减治疗;中药组给予补中益气汤加减治疗。观察2组治疗前后中医证候积分、西医临床绝对评分以及乙酰胆碱受体抗体前膜(AchR-QM)和乙酰胆碱受体抗体后膜(AchR-HM)滴度的变化,并评价2组的临床疗效。结果(1)总有效率:针药组总有效率为95.00%高于中药组的70.00%,χ^(2)=4.329,P=0.037,差异有统计学意义。(2)中医证候积分:2组中医证候积分治疗后均较前降低,差异均有统计学意义(t_(针药组)=29.749,t_(中药组)=13.858,均P=0.000);治疗后针药组积分低于中药组,差异具有统计学意义(t=-3.350,P=0.002)。(3)西医绝对评分:2组西医绝对评分治疗后均较前降低,差异均有统计学意义(t_(针药组)=23.136,t_(中药组)=13.728,均P=0.000);治疗后针药组评分低于中药组,差异具有统计学意义(t=-3.770,P=0.001)。(4)AchR-QM:2组患者血清中AchR-QM滴度治疗后较治疗前降低(t_(针药组)=28.288,t_(中药组)=17.824,均P=0.000);治疗后,针药组患者血清AchR-QM滴度低于中药组(t=-20.230,P=0.000)。(5)AchR-HM:2组患者血清中AchR-HM滴度治疗后较治疗前降低(t_(针药组)=9.388,t_(中药组)=9.147,均P=0.000);治疗后,针药组患者血清AchR-HM滴度低于中药组(t=-3.824,P=0.000)。结论电针联合补中益气汤加减治疗oMG具有较好的疗效,在改善临床症状及血清AchR-QM、AchR-HM滴度水平方面优于单纯中药治疗。OBJECTIVE To observe the clinical effect of electroacupuncture combined with Buzhong Yiqi decoction on ocular myasthenia gravis(OMG)cases.METHODS Forty patients with ocular myasthenia gravis from September 2018 to October 2019 were randomly divided into acupuncture and Traditional Chinese Medicine(ATCM)group(electroacupuncture combined with Buzhong Yiqi decoction,20 cases)and Traditional Chinese Medicine(TCM)group(Buzhong Yiqi decoction,20 cases).TCM symptom scores,clinical absolute scores of Western Medicine and acetylcholine receptor antibody of the AchR-QM and AchR-HM titers were compared before and after treatment between the two groups,and clinical efficacy of the two groups was evaluated.RESULTS(1)Total effective rate:The total effective rate of ATCM group was 95.00%,which was higher than that 70.00%of TCM group,the difference was statistically significant(χ^(2)=4.329,P=0.037).(2)TCM syndrome scores:The TCM syndrome scores in both groups decreased after treatment,the difference was statistically significant(t_(ATCM)=29.749,tTCM=13.858,all P=0.000);After treatment,the TCM syndrome scores in the ATCM group were lower than counterparts in the TCM group,the difference was statistically significant(t=-3.350,P=0.002).(3)Absolute scores of Western Medicine:The absolute scores of Western Medicine in the two groups were lower than before treatment,the difference was statistically significant(t_(ATCM)=23.136,t_(TCM)=13.728,all P=0.000).After treatment,the absolute scores of Western Medicine in the ATCM group were lower than that in the TCM group,the difference was statistically significant(P=-3.770,P=0.001).(4)AchR-QM:Serum AchR-QM titers in both groups decreased after treatment compared with those before treatment(tATCM=28.288,tTCM=17.824,both P=0.000).After treatment,serum AchR-QM titers in ATCM group were lower than counterparts in TCM group(t=-20.230,P=0.000).(5)AchR-HM:Serum AchR-HM titers in both groups decreased after treatment compared with those before treatment(t_(ATCM)=9.388,t_(TCM)=9.147,both P=0.000);Af

关 键 词：眼肌型重症肌无力 补中益气汤 电针 临床疗效 

分 类 号：R276.7[医药卫生—中医五官科学]